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Obstructive Lung Diseases |

Treatment Episodes of Maintenance Medications and Rates of COPD Exacerbations Among Patients With Chronic Bronchitis (CB)

Azza AbuDagga*, PhD; Shawn Sun, PhD; Hiangkiat Tan, MS; Abhishek Kavati, PhD; Caitlyn Solem, PhD
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HealthCore Inc, Wilmington, DE


Chest. 2012;142(4_MeetingAbstracts):673A. doi:10.1378/chest.1387625
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Abstract

SESSION TYPE: COPD Posters II

PRESENTED ON: Wednesday, October 24, 2012 at 01:30 PM - 02:30 PM

PURPOSE: To describe treatment episodes of maintenance medication regimens and associated chronic obstructive pulmonary disease (COPD) exacerbation rates in a real-world CB population derived from administrative claims data from 13 geographically dispersed commercial health plans, representing 45 million US lives.

METHODS: Inclusion criteria: Patients aged ≥40 years, with ≥2 years continuous enrollment, ≥1 hospitalization/emergency department (ED) visit or ≥2 outpatient visits with CB diagnosis (ICD-9-CM 491.xx) from 1/1/2004 to 5/31/2011, and ≥2 pharmacy fills for COPD medications during the most recent eligible year (the first fill served as the index date) were identified. This 1 year follow-up period was divided into treatment episodes (an episode required ≥2 consecutive fills of same treatment regimen; episode ended if (1) therapy changed (switch/add-on), or (2) therapy discontinued, or (3) follow-up ended). Exacerbations were categorized as severe (hospitalization with primary COPD diagnosis) or moderate (ED visit with primary COPD diagnosis or an oral corticosteroid filled within 7 days of COPD-related office visit). When multiple exacerbations occurred within a 14-day window, only one (most severe) was counted. Exacerbations per person-year (PPY) were calculated for various CB maintenance regimens.

RESULTS: 15,749 distinct treatment episodes from 10,519 CB patients were identified (49.95% female, mean age 67.5±11.0 years). Across all patients, the total person-years-exposed (in order of prevalence) were: Fixed Dose ICS+LABA (FDIL): 2,111; LAMA: 1,832; FDIL & LAMA: 1,315; ICS: 356; LABA: 183; LAMA & LABA: 117; LAMA & ICS: 85. Prevalence of severe/any exacerbations PPY by treatment regimen were: FDIL: 0.23/ 0.55; LAMA: 0.23/ 0.50; FDIL & LAMA: 0.28/ 0.71; ICS: 0.36/ 0.70; LABA: 0.25/ 0.60; LAMA & LABA: 0.19/ 0.57; LAMA & ICS: 0.21/ 0.56.

CONCLUSIONS: The most prevalent treatment regimens were FDIL, LAMA, and FDIL & LAMA. Regardless of the type of COPD maintenance medication regimen patients received during follow-up, they experienced exacerbations.

CLINICAL IMPLICATIONS: New strategies or treatment options should be considered to reduce exacerbations among CB patients.

DISCLOSURE: Azza AbuDagga: Consultant fee, speaker bureau, advisory committee, etc.: Consultant

Shawn Sun: Employee: Employee of Forest Research Institute

Hiangkiat Tan: Consultant fee, speaker bureau, advisory committee, etc.: Consultant

Abhishek Kavati: Consultant fee, speaker bureau, advisory committee, etc.: Consultant

Caitlyn Solem: Consultant fee, speaker bureau, advisory committee, etc.: Consultant

No Product/Research Disclosure Information

HealthCore Inc, Wilmington, DE

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